Organization
LITTLE RIVER MEDICAL CENTER, INC.
Active
Parent organization
LITTLE RIVER MEDICAL CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LITTLE RIVER MEDICAL CENTER, INC.
Authorized official
MRS. AVANGELA KAY CRISWELL (BUSINESS OFFICE DIRECTOR)
(843) 663-1013
Entity
Organization
Contact information
Practice address
7724 N KINGS HWY, MYRTLE BEACH, SC 29572-3041
(843) 839-3939
(843) 839-3946
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-1013
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
SC
122300000X
Dentist
—
SC
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC065
—
SC
05
—
ZA9656
—
SC
Enumeration date
12/06/2006
Last updated
12/09/2014
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